Individual
KLONIE L BEREND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
808 BROOK AVE, WICHITA FALLS, TX 76301-4209
(940) 766-0217
(940) 766-0730
Mailing address
808 BROOK AVE, WICHITA FALLS, TX 76301-4209
(940) 766-0217
(940) 766-0730
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
K9944
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
123761
SUPERIOR HEALTH PLAN
TX
01
—
85371R
BLUE CROSS BLUE SHIELD
TX
01
—
A018
HUMANA MILITARY HEALTHPLA
TX
01
—
MDK9944
WORKERS COMPENSATION
TX
Enumeration date
12/01/2006
Last updated
12/07/2007
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